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Eye clinic achieves high-availability systems, virtualization sans SAN

Dave Raffo

Like most health care organizations, storage is critical to Central Plains Eye MDs. The clinic’s data is growing rapidly and requires high-availability systems

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and long-term retention. Unlike larger firms, it does this without a physical storage area network (SAN) or a dedicated IT staff.

The Wichita-Kan.-based office relies heavily on digital electronic imaging records that need to be retained long term. To protect those records and the clinic’s business records, Central Plains Eye MDs uses 24 Dell servers and Dell PowerVault direct-attached storage (DAS) with Microsoft Hyper-V hypervisors and VM6 Software to replicate between servers.

Central Plains Eye MDs began in 2008 with two doctors, eight employees and about 600 patients. Practice manager John Pederson said it now has 16 employees and about 2,400 patients. Although Pederson still manages all of its technology, he doesn’t consider that his main job. He had 16 years experience working in IT before joining the clinic, but his main role now is to drive the bottom line.

“I’m not even really wearing an IT hat,” he said. “I’m a business guy. I spent the last three years making sure we make a profit. I don’t want to spend months in server rooms, installing operating systems, installing patches, upsizing them, moving things from one server to another.”

He wanted an IT setup that would be easy to maintain and wouldn’t put the company in debt from the start. He decided to virtualize as much as possible to make it easy to bring new servers and desktops online but that wasn’t easy on a strict budget.

“We wanted to minimize the need for outside contract IT help,” he said. “We want to be self-sustaining and operable. We need access to medical records everywhere in the clinic, including remotely. We are so image-driven that we know people more through their test results and images than by their faces. That has presented me some interesting challenges in virtualizing desktops and servers.”

Pederson said he looked at VMware and Citrix for virtualization but they were more geared toward larger organizations. He said Hyper-V “wasn’t quite there yet” in 2008, so he stared with Wyse thin clients and Windows Terminal Services (now Remote Desktop Services) to virtualize desktops. He added Hyper-V late last year when he went to Windows 7.

Around that time he saw a Twitter mention about VM6, then watched a webinar and was impressed.

VM6 creates an active cluster of Hyper-V servers, turning their internal disk drives into a logical pool of networked storage and creating a mirror between the servers.

Pederson especially liked that the software worked with disparate servers, which gives him flexibility when buying new equipment. “That’s one of the things that made it workable for me,” he said. “I can use whatever combination of storage and create logical units between VM6 nodes mirror between them.”

He installed VM6 at the end of 2010 with a cluster of three physical and eight virtual machines. He said performance was poor at first, but he changed his set up from RAID 5 to RAID 0 and saw a huge boost.

Pederson plans to add the clinic’s new electronic health records (EHR) system to the cluster when the ERH comes online. For now, he uses VM6 for accounting, time and attendance, and network management records. 

The clinic is mirroring between onsite servers, but Pederson said he plans to take a server off-site and replicate to it for disaster recovery.

Disaster recovery is just as important to a small medical center as it is to large enterprises,” he said. “We have tornadoes in Kansas and some floods. I’d like to have offsite hot backup—something that used to be available only to large enterprise-class IT.


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